ehealth IN INDONESIA: DEVELOPMENT STRATEGIES

Transcription

1 ehealth IN INDONESIA: DEVELOPMENT STRATEGIES Hari Kusnanto Gadjah Mada University, Indonesia Faculty of Medicine

2 THE CONTEXT: health situation in Indonesia

3 Indonesia: an Archipelago 238 million populations 33 provinces 530 districts/municipalities Double burden disease: 1. Communicable disease, Under-nutrition, MCH 2. Non Communicable Disease GDP per capita US $ Health expenditure/gpd 2.5% Adult literacy rate 92% Mobile network coverage 90% Mobile phone subscription 69%

4 Health Human Resources and Health Facilities 1,6 doctors per 10,000 population WHO Health for All-standard: 2/10,000 3,5 midwives per 10,000 population WHO Health for All standard: 2-4 / 10,000 2,4 nurses per 10,000 population WHO Health for All standard: 2-4/10,000 Hospitals: +/ Primary health centers +/ NOT EQUALLY DISTRIBUTED

5 Indonesia s Health System Challenges Stagnating Health Outcomes Geographic Inequalities Under-funding Inefficiencies (low utilization) Unsustainable financing Limited Health Insurance Coverage Weak Stewardship (World Bank, 2008)

6 RESPONSES BY HEALTH SECTOR

7 Secondary & Tertiary Care The Vision: UNIVERSAL COVERAGE Individual Care Primary Care Community Health Programs

8 INEQUITY OF HEALTH OUTCOMES agressive control consider elimination: shrinking the malaria map from the periphery Malaria Endemicity Level (WHO, 2009) malaria center

9 e-health SITUATION IN INDONESIA

10 e-health utilization of electronic communication and information technology to capture, transmit, store, and retrieve health data, information, and knowledge for clinical, educational, and administrative purposes at the local or remote site.

11 ehealth INITIATIVES IN INDONESIA Decentralized Piecemeal Fragmented Techno-centric Need Comprehensive Socio- Technical Approaches INFORMATION DIVIDE IN INDONESIA

12 Annual event of Indonesia Health Informatics Forum Yogyakarta (2010), Jakarta (2011) and Semarang (planned 2013) Inspired by Global Health Information Forum, Bangkok site visit (primary health center, district health office, hospital) -workshop (OpenMRS, Healthmapper) -conference (200 participants) -supported by WHO, GIZ, WB, Telkom OpenMRS workshop

13 IT Readiness

14 Continuing progress -OpenMRS translation into Indonesian language -specific module on Maternal and Child health -OpenMRS for tablet

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16 e-health STRATEGY DEVELOPMENT

17 e-health VISION: enabling information & knowledge delivery integrated into evidence-based clinical, programmatic, educational and administrative practices to ensure effective efficient & equitable health outcomes and self-sufficient health behavior

18 e-health vision resources capabilities challenges drivers core competence main opportunities e-health success factors development of e-health strategies e-health, it is a journey, not a destination!!!

19 surveillance reports accessible to the president in the form of dashboard participative development with strong and sustainable leadership e-health strategies useful usable operational affordable appropriate e-health H E A L T H O U T C O M E S

20 roadmap of health information system strengthening in Indonesia from 2011 to 2014

21 STRATEGIC ISSUES Regulatory, policy, advocacy frameworks Standards of processes and indicators Infrastructure development, including publicprivate partnership Uses of data, information and knowledge and put them into care, program and policy practices Improve resources (human, technology, financing) Monitoring, quality control and improvement Governance and change management

22 STRATEGIC GOALS 100% Provinces and 60% Districts/Cities implement integrated Health Information System in 2014 strategic policies for health information and e-health are in place in 2014

23 IMPLEMENTING ORGANIZATION EXPERT COMMITTEE RECOMMEND MINISTER OF HEALTH GOVERNANCE INDICATORS DATA SOURCES DATA MANAGEMENT DISSEMINATION AND USES OF DATA SYSTEMS IMPROVEMENT INFRASTRUCTURE WORKING GROUPS COORDINATED BY DIRECTOR OF CENTER FOR HEALTH DATA AND INFORMATION, INDONESIAN MINISTRY OF HEALTH

24 strategic goals strategic issues strategic analyses Standards and components GOVERNANCE INDICATORS DATA SOURCES DATA MANAGEMENT SYSTEMS IMPROVEMENT INFRASTRUCTURE national health & ICT policy mission, strategic intent for HIS VISION integrated health information system for health development to improve health outcomes and self-sufficient health behavior Health contexts and HIS situation DISSEMINATION AND USES OF DATA Monitoring, Evaluation and Improvement e-health as sine qua non